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New vs Established Patient

  1. #1
    Question New vs Established Patient
    Medical Coding Books
    Good afternoon all,

    If one of our doctors performs an arteriogram on a patient, and then that patient comes into the clinic to discuss the result and any treatment options, would that patient be a New Pt or would they now become an Established Pt?

    What if they were first seen for something non-invasive like a CT or MRA?

    Any help would be greatly appreciated.

    Thank you.

  2. #2
    North Carolina
    Arteriogram perform (face to face met) and returns to office for results and TX plan---established

    Interpret the phrase “new patient” to mean a patient who has not received any professional services, i.e., E/M service or other face-to-face service from the physician or physician group practice (same physician specialty) within the previous 3 years.

    If the CT/MRA is only interpreted...New

    For example, if a professional component of a previous procedure is billed in a 3 year time period, e.g., a lab interpretation is billed and no E/M service or other face-to-face service with the patient is performed, then this patient remains a new patient for the initial visit
    . An interpretation of a diagnostic test, reading an x-ray or EKG etc., in the absence of an E/M service or other face-to-face service with the patient does not affect the designation of a new patient.

    I just noticed this question on another forum--Looks like Laura and I are in sync
    Last edited by RebeccaWoodward*; 05-06-2009 at 01:12 PM.

  3. #3
    Default New vs Established Patient
    That's what I thought. Just wanted to be sure. Thanks for your quick response!

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